Under the leadership of its current Commissioner, John Auerbach, the Massachusetts Department of Public Health has identified the elimination of racial and ethnic disparities in health as one of its most important priorities. The proposed Reducing Environmental Asthma Disparities in Youth (READY) study reflects the Department's mission and priorities. The proposed READY study will examine how race, ethnicity, country of origin of parents, language, socioeconomic status, insurance status and education level of parents will influence the ability of the intervention to reduce health disparities. The study will enroll 400 low-income families with children ages 2-11 years with diagnosed asthma for a one-year home-visiting intervention implemented by community health workers. Participants will be patients at one of four clinical sites - a hospital- based asthma clinic in Boston with a predominantly African-American population, a neighborhood health center in Boston with a predominantly Caribbean/Haitian population born outside the US, a large community health center in the city of Lawrence, Massachusetts, serving a predominantly Hispanic population and a large non- profit, multi-specialty medical group practice in Boston serving white and minority patients with both private and public insurance. The study hypothesis is that the combination of two proven interventions - the Seattle Healthy Homes model, which addresses substandard housing conditions that exacerbate asthma, and the Wee Wheezers education curriculum, which improves parent understanding of asthma and raise parental expectations - together will reduce disparities in asthma symptom control for children ages 2 to 11 years among racial and ethnic minorities, and can be adopted in different health care settings for different racial and ethnic populations. Community Health Workers (CHWs) will ensure that the interventions are effectively deployed and will facilitate communication between patients and providers. The proposed study has three specific aims: 1) The READY intervention will reduce racial and ethnic disparities in substandard housing conditions that exacerbate asthma, such as pest infestations and mold exposure and improve parental understanding in the importance of reducing asthma triggers;2) The READY intervention will reduce racial and ethnic disparities in parental expectations of asthma control and improve concordance between health care provider and parental reports of asthma control for better communication in asthma management;and 3) The READY intervention will reduce racial and ethnic disparities in asthma morbidity and disability. PUBLIC HEALTH RELEVANCE: The proposed Reducing Environmental Asthma Disparities in Youth study will examine significant pediatric asthma disparities by race, ethnicity and income and the contribution of differing environmental exposures, particularly substandard housing which is commonly found in neighborhoods where children from low income and racial and ethnic minority populations live.